Wednesday, August 09, 2006

We got a call today at the office...

...from our group insurance company.

It seems they’d received a request for an insurance card from an employee who had never carried the health insurance. They wondered if we (the two people in HR) knew what was going on. We didn’t, so we asked the person to swing by the HR office.

She told us, “But I’ve always had the insurance—from day one! The money’s been coming out of my paycheck.”

(“Day one” was May 1, 2005. That’s when we had our enrollment in the new plan.)

We showed her the enrollment form. At the top she was supposed to select the coverage desired, and nothing was selected. “Oh,” she said, “I must have missed that little box. But look, down at the bottom. There’s a place where I have to waive coverage if I don’t want it and sign the form. I checked that I was waiving DEPENDENTS coverage, but not EMPLOYEE.”

She was right. I pointed out that the money deducted from each of her checks was only a few dollars, and THAT was to cover the life insurance she’d opted for, plus the Long Term Disability coverage. Health insurance was MUCH more expensive.

With a blank look she said, “Oh. I never paid any attention.”

Then I pointed out that on May 1 of THIS YEAR we had announced a significant rate increase. Hadn’t she noticed that her deduction stayed the same?

“No.”

So why did she now decide she wanted an insurance card?

“I went to the doctor’s last week and they wanted a copy of my card, but I didn’t have one.”

I huddled (on the phone) with our carrier, and later presented her with two options:

1. Fill out a new enrollment form, date it April, 2005, indicate that you DO want coverage, pay us the last 15 months worth of employee contributions (well over $1,000), and you’ll have full, regular coverage. (Remember, until now she’s had NO claims of any kind.)

2. Fill out an enrollment form dated April, 2006 (our last annual “late enrollment” window), indicate that you now want coverage, pay us the last 3 1/2 months of employee contributions (over $300), and you’ll have coverage. BUT as a late enrollee, you’ll have a “pre-existing condition limitation.” The plan will exclude any condition for which you’ve received treatment in the last 18 months.

She smiled at this no-brainer choice. “I haven’t had any claims for over 18 months, so I’m sure I have no ‘pre-ex’ conditions. I’ll take option 2.”

My response?

“Good choice. But from now on, pay attention to the deductions from your pay, and ask about any that don’t seem right, OK?”

She nodded. We’ll see. (No, she is NOT blonde.)

9 comments:

r.e.wolf said...

Ooh, I think I used to work with her! Or date her....

Christina said...

Duuuhhhhh!

kenju said...

That could happen to me. I am so used to letting someone else take care of insurance that I might not notice either.

Karyn Lyndon said...

You are treading on very thin ice with the blonde comment...

robotJAM said...

This is why I like the UK, we get all this health stuff for free and no complicated forms to fill in.

All I have to do is contribute 10% of my salary each month and then if I need to goto the doctors I book in and 6 months later I get it all for "free". Its amazing !!!

Duke_of_Earle said...

To: All commenters above...

Thanks for the perspectives. Seriously! Of course our insurance provider felt she was "dumb like a fox" and trying to get a free ride until she had her fisrt claim, then jump up and say wide-eyed, "I thought I had it all along!" But, as Kenju points out, quite a LOT of people pay little attention to the amounts deducted from their pay.

Thanks to RobotJAM for the UK perspective. Our system has many faults, but many of the alternative systems have faults of their own.

And Karyn, that was just a humorous reference to a stereotype, and not intended as a personal slur. But if the shoe fits...

John (Deeper in trouble now than before, I suspect.)

Monica said...

My ABSOLUTE favorite part? You let us know she's not a blonde...I LOVED IT.

Hey, here's a blonde revenge joke: Why are blonde jokes so short?

So brunettes can understand them! :)

M.E Ellis said...

Awww poor woman!

:o)

Kirsten said...

Ah, blondes -- the last available butt-for-jokes left standing after how many years of rule by the PC police . . .

As a blonde myself, I say go for it!

But I'm feeling pretty good today, John, I played my first full 18 holes w/ my dad, shot a 109 -- my best game yet -- I've started using my driver and smoked a couple about 200 yards, which was a lot of fun -- if my short game hadn't been a mess I might even have parred a hole or two!